CBD Oil for Pain: Research, Side Effects, Dosage & Case Studies

CBD is one of many naturally occurring compounds found within the hemp plant1. These compounds, referred to as cannabinoids, possess ‘therapeutic effects’ due to their interaction with an influential biological system called the endocannabinoid system2. CBD can be ingested in a variety of forms and reassuringly doesn’t induce the ‘high’ commonly associated with other cannabis or marijuana plants, which is caused by a different cannabinoid called THC3. CBD products are required by law to possess a negligible and often undetectable amount of THC, meaning you can safely reap the benefits of this multifaceted plant without the risk of psychotropic side effects4.

Many people use CBD, particularly CBD oil, to manage symptoms of pain. In this article, we look at the research behind using CBD oil for pain, exploring its effectiveness and the implications for consumers.

What is pain? The science.

Pain is an important reaction in the body which is perfectly normal to experience. It is how your nervous system alerts you to a possible injury or area of concern. These pain signals are fired from receptors in the injured area through your spinal cord and onto your brain so that we register the presence of a problem5.

In addition to more common everyday pains, CBD is also being investigated as a way to manage chronic pain. With incidents of chronic pain, the body repeatedly sends pain signals to the brain, even if the injury has completely healed6. This sensory malfunction can reduce mobility, limit flexibility and cause issues with strength and endurance. To make matters worse, chronic pain can last for years. Medically, chronic pain is defined as pain that lasts for more than 3 months. It may be an ache, burning sensation or sharp shooting pain which is experienced either constantly or intermittently7.

Using CBD for pain

Cannabinoids found in the hemp plant, such as CBD, interact with an integral biological infrastructure known as the endocannabinoid system (ECS). The ECS has been shown to regulate stability within the body and aid in returning your internal environment to a state of equilibrium, known as homeostasis8 9 10.

“The regulation of pain is one of the earliest medical applications of cannabinoids.”11

As previously mentioned, pain serves to notify of problems within the body, indicative of an unstable internal environment. In response to this, our ECS gets to work solving the problem and returns our systems to a state of homeostasis. This process applies equally to an array of symptoms constituting a lack of homeostasis such as chronic pain, inflammation and nerve function12 13.

Research shows CBD interacts with the endocannabinoid system in such a way that it can beneficially influence aforementioned issuesxi. Furthermore, in 2018, a review summarising more than 30 years of research into chronic pain concluded that CBD was an effective tool for managing pain without any negative side effects14. It is perhaps for this reason that many users are choosing CBD to help with pain, not forsaking the 5000-year history of pain relief that this plant beholds15.

woman sitting on floor wearing distressed denim jeans
Photo by Imani Bahati on Unsplash

CBD for period pain

CBD’s effect on period pain presents an illuminating example of the way this naturally occurring compound could both holistically and specifically mitigate unwanted symptoms.

Period pains, cramps and contractions can all be attributed to the presence of Prostaglandin, an inflammatory chemical that is released after ovulation. Women with higher levels of this chemical are found to experience an increase in period pain.

As it stands, there is insufficient scientific research to concretely verify the claims that CBD can be used to help with period pain. However, due to its proven anti-inflammatory properties, it stands to reason that the CBD could be used to target menstrual discomfort and pain which is caused by an inflammatory hormone. Following this logic, a 2019 study reviewed the “viability of using cannabidiol (CBD) as a treatment option for PMS” and concluded that “CBD is a viable option for managing menstrual symptoms.”16

In addition, scientists recently discovered that CBD can actually reduce the amount of prostaglandin being produced by the body in the first place, which would address the issue at the source before negative symptoms arise. More clinical trials are needed to offer substantial medical evidence, but initial results and anecdotal evidence are encouraging.

surfer stretching his back
Photo credit: Unsplash

CBD for back pain

According to the 2000 ‘National Health Interview Survey’, 8% of all adults in America experienced persistent or chronic back pain, amassing 12 billion dollars in direct health care costs and indirect expenses each year17. Since then, a 2011 publication claimed that this number may have reached as high as 635 billion dollars annually, correlating with an increase in cases of back pain18.

With millions of people across the world suffering from chronic or persistent back pain, it’s no surprise that people are searching for alternatives to orthodox solutions which don’t appear to be working. Further to the statistical implication of an ever-increasing prevalence of back pain, we have a drug epidemic of drastic proportions relating to opioid type drugs that are commonly administered to sufferers of this ailment19.

Fortunately, using CBD for back pain has shown positive results throughout studies, testimonials and historic clinical success20 21. Back pain tends to stem from inflammatory or neuropathic issues, both of which are known to be susceptible to cannabinoids through direct influence or interaction with the endocannabinoid system22 23 24 25. Due to the positive effects that cannabinoids have displayed, they have been suggested as a way to reduce the opioid dosing in patients suffering from back pain, a prescriptive trend which may combat the firm bond between back pain and opioid addiction26 27 28.

skateboarder rubbing his wrist
Photo credit: EthicaCBD

CBD for nerve pain, CBD for gout, CBD for arthritis… and so on

All in all, there’s solid foundational research showing CBD as an effective pain reliever, but further clinical trials are required to undeniably prescribe CBD as a treatment for specific problems such as nerve pain, gout, arthritis and so on29.

That being said, research illuminates CBD as an anti-inflammatory, so there is logic to suggest that sufferers of inflammation-based symptoms, such as gout, would benefit from CBD. Equally, studies have demonstrated the positive effect of CBD on the endocannabinoid system and the subsequent potential benefits of this span a vast range of health issues, including neuropathy (nerve pain). Since 2003, CBD has been explored in clinics as a treatment for pain when traditional methods have failed, so if side effects remain negligible, the full potential of this versatile plant will likely be realised30 31.

What kind of CBD is used for pain?

To be clear, CBD is CBD…it stands for cannabidiol, a chemical compound found in the hemp plant which exhibits pain relieving effects. However, there are various CBD products available on the market which present this compound in different forms. Theoretically, all of them can be used for pain, but some will be more effective than others.

The reason for this variation in effectiveness stems from how appropriately the application is matched to the problem. For example, when using CBD for back pain caused by inflammation, a topical transdermal (on the skin) solution may be more effective than oral solutions32 33. This is because the CBD is absorbed through the skin directly to the area of need. In contrast, if the back pain was caused by chronic illness or neuropathy, an oral solution may be more effective as it holistically interacts with the mechanisms that govern the problem34. Even then, there is no esteemed ‘best CBD oil for pain’ on the market and it’s common for people to experiment with various solutions before finding an appropriate match.

hand holding cbd dropper containing cbd oil
Photo credit: EthicaCBD

CBD Dosage for Pain

CBD dosing specifications are an area of research which certainly require further development. However, in 2011, a review stated that “chronic use and high doses up to 1,500 mg/day of CBD are reportedly well tolerated in humans”, which is the equivalent of drinking a whole 10ml bottle of 15% CBD oil in one day35. More recently, a 2017 review substantiated those findings, detailing various examples of successful human treatments within the range of 10-1500mg36

Specific dosage recommendations for pain depend on multiple variables, such as condition, body weight and other medication, making it difficult to provide a blanket CBD dosage for pain. Consult your doctor to discuss dosage in more personal detail, especially if coupling CBD with other medication.

Since CBD is still relatively unavailable as a prescription in many countries, consumers will often only have to access it as a food supplement, where safe maximum dosages are specifically defined. In the UK, for example, maximum dosage for CBD as a food supplement is currently 70mg per day37

Safety of CBD – Side effects of using CBD for pain

CBD has been found to be perfectly safe and there are no reports of any long-term or dangerous complications resulting from the consumption of CBD. As with any natural substance, there is the potential for unwanted side effects, but these instances are very rare.

Possible side effects include a dry mouth, diarrhoea, fatigue, and drowsiness. Perhaps the most pertinent consideration when taking CBD is the impact it might have on other medication38. For those on prescribed medicines, it is important to speak to your doctor before introducing CBD into your daily routine39.

So…does CBD treat pain?

All things considered, evidence strongly suggests that CBD is an effective treatment for pain. The success stories are compelling and too many people have reported positive experiences with CBD for the claims to be unfounded. However, as with all matters of health and well-being, there is an overarching tone of subjectiveness and CBD case studies will repeatedly show variation in the magnitude of pain relief displayed per subject.

As always, we invite you to expand your knowledge in this ever-growing field of research by exploring the CBD studies in the reference list below.


1Shannon, S. Lewis, N. Lee, H. & Hughes, S. (2019) Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal23, 18–041. Available at: https://doi.org/10.7812/TPP/18-041

2Marco E, García-Gutiérrez M, Bermúdez-Silva F, Moreira F, Guimarães F, Manzanares J, Viveros M. (2011) Endocannabinoid system and psychiatry: in search of a neurobiological basis for detrimental and potential therapeutic effects. Frontiers in Behavioral Neuroscience, 5, 63. Available at: https://www.frontiersin.org/article/10.3389/fnbeh.2011.00063

3Martínez, V. Iriondo De-Hond, A. Borrelli, F. Capasso, R. Del Castillo, M. D. & Abalo, R. (2020). Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals?. International journal of molecular sciences21(9), 3067. Available at: https://doi.org/10.3390/ijms21093067

4Alphagreen (2021) Regulating CBD in the UK: FSA guidance & legislation, Alphagreen. Available at:

5Basbaum, A. I., Bautista, D. M., Scherrer, G., & Julius, D. (2009). Cellular and molecular mechanisms of pain. Cell, 139(2), 267–284. Available at: https://doi.org/10.1016/j.cell.2009.09.028

6Ambardekar, A (2019) Do I Have Chronic Pain? WebMD. Available at: https://www.webmd.com/pain-management/guide/understanding-pain-management-chronic-pain

7Treede, R. D. Rief, W.,Barke, A. Aziz, Q. Bennett, M. I. Benoliel, R. Cohen, M. Evers, S.nFinnerup, N. B. First, M. B. Giamberardino, M. A. Kaasa, S. Kosek, E. Lavand’homme, P. Nicholas, M. Perrot, S. Scholz, J. Schug, S. Smith, B. H. Svensson, P. Wang, S. J. (2015). A classification of chronic pain for ICD-11. Pain156 (6), 1003–1007. Available at: https://doi.org/10.1097/j.pain.0000000000000160

8Marco E. M. Vivieros, M. P. (2009) The critical role of the endocannabinoid system in emotional homeostasis: avoiding excess and deficiencies. Europe PMC,  9(12):1407-1415. Available at: https://europepmc.org/article/med/19929814

9Li, C. Jones, P. Persaud, S. (2011) Role of the endocannabinoid system in food intake, energy homeostasis and regulation of the endocrine pancreas, Pharmacology & Therapeutics, 129 (3), 307-320,Available at: https://doi.org/10.1016/j.pharmthera.2010.10.006.

10Silvestri, C. Di Marzo, V. (2013) The Endocannabinoid System in Energy Homeostasis and the Etiopathology of Metabolic Disorders, Cell Metabolism, 17 (4), 475-490. Available at: https://doi.org/10.1016/j.cmet.2013.03.001

11Zou, S., & Kumar, U. (2018) Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International journal of molecular sciences19(3), 833. Available at: https://doi.org/10.3390/ijms19030833

12 13Fine, P. G., & Rosenfeld, M. J. (2013) The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides medical journal4(4), e0022. Available at: https://doi.org/10.5041/RMMJ.10129

14Vuckovic, S. Srebro, D. Vujovic, K. Vucetic, C. Prostran, M. (2018) Cannabinoids and Pain: New Insights From Old Molecules, Frontiers in Pharmacology. 9. 1259. Available at: https://doi.org/10.3389/fphar.2018.01259

15Mechoulam R. The Pharmacohistory of Cannabis sativa, in Cannabis as Therapeutic Agent. CRC Press; Boca Raton, FL, USA: 1986.

16Cavner, J. Smith, F. Gray, B. (2019) Is CBD A Viable Option for Menstrual Symptoms? Online Journal of Complementary & Alternative Medicine. Available at: https://www.researchgate.net/

17Shirey, L. Rogers, S. Chronic Back Pain, Health Policy Institute. Available at: https://hpi.georgetown.edu/backpain/.

18Institute of Medicine (US) Committee on Advancing Pain Research C, and Education. Relieving pain in America: a blueprint for transforming prevention. Care, Education, and Research. Washington (DC): The National Academies Press; 2011.

19Deyo, R. Korff, M. Duhrkoop, D. (2015) Opioids for low back pain, The BMJ. Available at: https://www.bmj.com/content/350/bmj.g6380

20Mondello, E., Quattrone, D., Cardia, L., Bova, G., Mallamace, R., Barbagallo, A. A., Mondello, C., Mannucci, C., Di Pietro, M., Arcoraci, V., & Calapai, G. (2018). Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain. Journal of pain research11, 1761–1767. Available at: https://doi.org/10.2147/JPR.S166617

21M, Pinsger. (2012) Benefit of an add-on-treatment with a synthetic cannabinomimeticum on patients with chronic back pain-a randomized controlled trial, 8th International Conference on Early Psychosis: From Neurobiology to Public Policy. Published in: European Spine Journal. 2012;21(11):2366

22Van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654-662.

23Isabela Maia da Cruz Fernandes IM, Pinto RZ, Ferreira P, Lira FS. Low back pain, obesity, and inflammatory markers: exercise as potential treatment. J Exerc Rehabil. 2018;14(2):168-174.

24Maldonado R, Baños JE, Cabañero D. The endocannabinoid system and neuropathic pain. Pain. 2016;157(Suppl 1):S23-S32.

25Fitzcharles MA, Baerwald C, Ablin J, Häuser W. Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis). Schmerz. 2016;30(1):47-61.

26Abrams DI, Jay CA, Shade SB, et al. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology. 2007;68(7):515-521.

27Nielsen S, Sabioni P, Trigo JM, et al. Opioid-sparing effect of cannabinoids: a systematic review and meta-analysis.Neuropsychopharmacology. 2017;42(9):1752-1765.

28Wilkerson RG, Kim HK, Windsor TA, Mareiniss DP. The opioid epidemic in the United States. Emerg Med Clin North Am. 2016;74(5):278-279.

29Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management4(1), 245–259. https://doi.org/10.2147/tcrm.s1928

30Argueta, D. A., Ventura, C. M., Kiven, S., Sagi, V., & Gupta, K. (2020). A Balanced Approach for Cannabidiol Use in Chronic Pain. Frontiers in pharmacology11, 561. Available at: https://doi.org/10.3389/fphar.2020.00561

31Grinspoon, P. (2018) Cannabidiol (CBD) — what we know and what we don’t, Harvard Health Publishing. Available at: https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont.

32Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain (London, England)20(6), 936–948. Available at: https://doi.org/10.1002/ejp.818

33Bruni, N., Della Pepa, C., Oliaro-Bosso, S., Pessione, E., Gastaldi, D., & Dosio, F. (2018). Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules (Basel, Switzerland)23(10), 2478. Available at: https://doi.org/10.3390/molecules23102478

34Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245–259. https://doi.org/10.2147/tcrm.s1928

35Bergamaschi, M. M., Queiroz, R. H., Zuardi, A. W., & Crippa, J. A. (2011). Safety and side effects of cannabidiol, a Cannabis sativa constituent. Current drug safety6(4), 237–249. https://doi.org/10.2174/157488611798280924

36Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research2(1), 139–154. https://doi.org/10.1089/can.2016.0034

37FSA (2020) Food Standards Agency sets deadline for the CBD industry and provides safety advice to consumers, Food Standards Agency. Available at: https://www.food.gov.uk/news-alerts/news/food-standards-agency-sets-deadline-for-the-cbd-industry-and-provides-safety-advice-to-consumers

38Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research2(1), 139–154. Available at: https://doi.org/10.1089/can.2016.0034

39Brown, J. D., & Winterstein, A. G. (2019). Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. Journal of clinical medicine8(7), 989. https://doi.org/10.3390/jcm8070989